Background to this inspection
Updated
17 June 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We planned this inspection to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team
The inspection team consisted of two inspectors and two experts by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. The service had a manager registered with the Care Quality Commission. This means that they and theprovider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We carried out the inspection visit on 26 May 2021. We gave a short period notice of the inspection as we were mindful of the impact and added pressures of Covid-19 pandemic on the service. This meant we took account of the exceptional circumstances and requirements arising as a result of the COVID-19 pandemic.
What we did
We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a provider information return prior to this inspection due to the timing of the inspection.This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During our inspection we went to the service's office and spoke with the registered manager, the regional manager and five care staff. We looked at four care records and three staff records; we also looked at various documents relating to the management of the service. We discussed quality assurance with the registered manager and regional manager and the actions they had taken since the last inspection to improve quality, and planned changes. We also received feedback from the local authority commissioning team. After the inspection visit, we spoke to five relatives and 18 people who used the service.
Updated
17 June 2021
Concept Care Solutions Ltd (Edgware) is a domiciliary care agency providing personal care to 41 people at the time of the inspection. The service supported older people, children and young adults with physical and learning disabilities, mental health needs, Autism and Asperger's.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
People’s experience of using this service
People told us people they were happy with the care and support they received because they felt safe and their needs were met by kind and caring staff.
At the last inspection we found there were breaches of the regulations. Safeguarding incidents and allegations of abuse had not always been properly managed or reported as necessary to the Commission. Robust governance was not in place; audits and checks had been ineffective in driving the necessary improvements, and staffing levels were not always safe. At this inspection Improvements had been made in all these areas.
People had access to healthcare services and were involved in decisions about their care. Partnerships with other agencies and health professionals enabled effective outcomes for people. Staff supported people to take medicines safely.
Risks to people were assessed and regularly reviewed. Staff understood the actions needed to minimise the risk of avoidable harm including the prevention of infection. Staff had completed safeguarding training and understood their role in identifying and reporting any concerns of potential abuse or poor
practice. There were improved systems in place to record or track incidents and allegations of abuse.
People and staff praised the managers of the service and agreed that they were approachable, knowledgeable, fair and did their job well. The staff team worked well together and supported the registered manager.
The staff team was committed to providing a high-quality service. They had undertaken training so that they were skilled and knowledgeable to effectively meet people’s needs. Staff understood their responsibilities to report any concerns.
Staff encouraged people to be as independent as possible and respected people’s privacy and dignity.
People were given choices about the way in which they were cared for. Staff listened to them and knew their needs well. Care plans contained information about each person’s individual support needs and preferences in relation to their care and we found evidence of good outcomes for people. When people did not have the capacity to make their own decisions, staff maximised their involvement and made decisions in their best interests, in accordance with legislation.
Recruitment practices were safe and relevant checks had been completed before staff worked at the service.
People told us that staff were able to meet their needs and were respectful of their individual preferences. Relatives told us staff who supported their loved ones were kind and caring.
People confirmed the service did not miss any care calls and that staff were usually on time.
People received care and support from a small group of staff, which provided consistency.
The managers of the service actively sought the views of people and their relatives about the running of the service and they dealt promptly with any concerns that people raised.
The provider had systems in place to monitor and improve the quality and safety of the service provided.
More information is in the full report.
Rating at last inspection
The last rating for the service was requires improvement (published 3 December 2019).
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
We undertook this focused inspection to check they had followed their action plan and to confirm they now
met legal requirements. This report only covers our findings in relation to the Key Questions, Safe, Responsive, Caring and Well-Led which contain those requirements. At this inspection we found improvements had been made and the provider was no longer in breach of regulations. The ratings from the previous comprehensive inspection for those Key Questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If we receive any concerning information, we may inspect sooner.